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170 THE EFFECTS OF MEDICATIONS AND VENTILATOR MANAGEMENT ON WEIGHT GAIN OF EXTREMELY LOW BIRTHWEIGHT INFANTS IN THE PERI-EXTUBATION PERIOD
  1. D. M. Coulter,
  2. L. M. Moyer-Mileur
  1. University of Utah, Salt Lake City

Abstract

Both respirator support and medications used to facilitate extubation of premature babies potentially affect weight gain. We reviewed the charts of 100 pts whose birth weights were ≤1 kg and who had received full enteral feedings for at least 7 days before and after extubation. We determined the effects of ventilator support (SIMV, NCPAP) and medications (caffeine, theophylline, dexamethasone) on weight gain normalized for weight and caloric intake (gm/kg/Kcal/d) for the 7 days prior to and after extubation, excluding the day of extubation, a total of 1400 observations. (Table)

Dexamethasone therapy dramatically reduced growth, a result previously reported. Methylxanthines had absolutely no effect on calorie utilization for growth. NCPAP caused a 20% reduction in growth, a result that was statistically insignificant. The known imprecision of daily weights in small babies may mask a clinically significant difference in growth of small babies on NCPAP. Despite the use of dexamethasone and NCPAP in the post-extubation period, extubation resulted in a small increase in weight gain. Prolonging mechanical ventilation in these tiny babies carries known risks and does not promote growth.

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